Topical Glycopyrrolate for Treatment of Hyperhidrosis

Excessive sweating, or hyperhidrosis, is a socially embarrassing disorder and may negatively impact the quality of life. In order of frequency, palmar-plantar, palmar-axillary, isolated axillary, and craniofacial hyperhidrosis are distinct disorders.

Application of topical glycopyrrolate 2% “appears to be effective and safe for the treatment of excessive facial sweating in primary craniofacial and secondary gustatory hyperhidrosis following sympathectomy”.

Ten patients with compensatory sweating after sympathectomy applied one millilitre of a 2% water solution of topical glycopyrrolate once a day over the affected area and massaged for 30 seconds. Eight of the 10 treated patients dramatically improved with the topical application of glycopyrrolate. Two patients quit the treatment due to secondary effects (optical accommodative failure and dry mouth). The results of the study demonstrated that local application of glycopyrrolate might be the treatment of choice for compensatory hyperhidrosis.

“Glycopyrrolate iontophoresis is more effective than tap water iontophoresis in the treatment of palmoplantar hyperhidrosis” and “glycopyrrolate iontophoresis has both local and systemic effects on perspiration”.

Br J Dermatol. 2008 May;158(5):1094-7.Topical glycopyrrolate for patients with facial hyperhidrosis.Click here to access the PubMed abstract of this article.

Dermatol Ther. 2008 Sep-Oct;21(5):406-8. A medical alternative to the treatment of compensatory sweating.Click here to access the PubMed abstract of this article.

Australas J Dermatol. 2004 Nov;45(4):208-12. Iontophoresis with glycopyrrolate for the treatment of palmoplantar hyperhidrosis.Click here to access the PubMed abstract of this article.

Lidocaine 8% Intranasal Spray for Trigeminal Neuralgia

Intranasal lidocaine 8% administered by a metered-dose spray produced prompt but temporary analgesia without serious adverse reactions in patients with second-division trigeminal neuralgia.

Daily application of sucralfate gel to non-infected post-phlebitis/vascular ulcers for 42 days led to complete healing in 95.6% of patients compared to only 10.9% of cases that used placebo.1

A 10% aqueous solution of sucralfate, administered twice daily as a rectal enema or vaginal douche, was also used successfully to treat radiation-induced rectal and vaginal ulcers. 2, 3

Topical sucralfate represents a safe, inexpensive and effective therapeutic intervention, particularly for those patients with high output or short stomas where repeated stoma leakage may be unavoidable.4

Betahistine at oral doses of 16 mg tid and 24 mg bid provides similar efficacy and tolerability in the treatment of vertigo in patients with Meniere's disease.

The efficacy and safety profile of betahistine in the treatment of vertigo due to peripheral vestibular disorders was confirmed.

Acta Otolaryngol. 2008 Jul 10:1-6.Effects of semicircular canal electrode implantation on hearing in chinchillas.Click here to access the PubMed abstract of this article.

Acta Otorhinolaryngol Ital. 2001 Jun;21(3 Suppl 66):1-7Betahistine in the treatment of vertigo. History and clinical implications of recent pharmacological researches.Click here to access the PubMed abstract of this article.

Accumulating evidence suggests that Low Dose Naltrexone can promote health supporting immune-modulation which may reduce various oncogenic and inflammatory autoimmune processes. Since LDN can upregulate endogenous opioid activity, LDN may also play a role in healing and repair of tissues, as well as promoting stress resilience, exercise, social bonding, and emotional well-being, and ameloriating psychiatric problems such as autism and depression.

Chronic anal fissures can be simply and effectively treated medically without the risk of incontinence associated with sphincterotomy. Topical nifedipine can be beneficial, alone or after botulinum toxin injections ("an excellent combination" associated with a low recurrence rate and minimal side effects).

The "rectal rocket" is a special suppository designed to treat haemorrhoids, which features a contoured front end and a flared bottom. The flared bottom remains in continual contact with the anal sphincter and outer surface of the anus for 4 to 6 hours, to treat external as well as internal haemorrhoids. There is also a slit for flatulence running the length of the suppository that allows the patient to pass gas without losing the suppository. The rectal rocket was designed by compounding pharmacists to deliver pain relievers and anti-inflammatories, such as lidocaine and hydrocortisone, directly to painful haemorrhoids. Rectal rockets are also regularly prescribed for women who have recently given birth. This unique dosage form can also be formulated to contain additional medications such as misoprostol and sucralfate, and also can be used to treat anal fissures.

Int'l J of Pharm Compounding May/June 2007; 11(3):194-9The Rectal Rocket: A Two-Day Treatment for HemorrhoidsClick here to access the abstract of this article.